Ocular Rosacea: Symptoms, Causes, and Treatment

This article will focus on the symptoms, causes and treatments of a common disorder called ocular rosacea. This condition is a subtype of a chronic skin condition called acne rosacea, which affects about 13 million people in the United States.

Researchers do not know how many people with acne rosacea also get the type that affects the eyes, though some suspect it can be as much as 60 percent. It mostly strikes adults between 30 and 50 years old. Often, ocular rosacea is the first sign that acne rosacea is developing. A person does not have to have acne rosacea to get ocular rosacea.

Ocular rosacea is not life-threatening, but it can threaten a person’s vision if it affects the cornea. The risk of this is increased if the patient also has dry eyes. As of 2018 ocular rosacea is not curable, and its symptoms flare up, and go into remission. However, symptoms can be controlled with the right treatment. There are no tests needed to determine if a patient has the condition. The doctor can tell by examination and listening to the patient’s description of their symptoms.

What Is Ocular Rosacea?

Ocular rosacea is a type of inflammation that affects the eye, causing redness, itching and burning. It mostly affects women, and some women first experience it when they enter menopause. However, if a man contracts the disease he’s more likely to have a severe form of it. This can include scarring of the eyelids or ulceration of the cornea and infection. An infection can infiltrate the eye and lead to loss of vision.

Ocular rosacea is not contagious, and treating and managing it are not particularly difficult. However, patient needs to be dedicated to taking care of their eyes to make recurrences of the condition less severe.

Symptoms of Ocular Rosacea

Ocular rosacea symptoms are:

Eyes that burn or sting.

Dry eyes.

Itching eyes.

A feeling that there is grit or sand in the eye.

Blurry vision.

Tearing.

Photophobia, or increased sensitivity to light.

Blepharitis, or eyelids that are red and swollen.

Spider veins in the eye.

Styes in the margins of the eyelid.

People who have these symptoms need to see either an ophthalmologist or dermatologist as soon as possible to both ease their symptoms, and prevent complications.

Causes of Ocular Rosacea

Doctors are not sure what causes ocular rosacea. Like acne rosacea, heredity and environment are believed to be factors. It’s also been found that the oil glands at the edges of the eyes of most people who have this type of rosacea are blocked. Since these glands keep the area around the eye lubricated, the blockages can cause the eyelids to become irritated, red and itchy.

The eyelashes may also develop crusts and flakiness. Some researchers believe that there’s a link between the condition and gut bacteria, or there’s a link between ocular rosacea and problems with the patient’s capillaries. Others believe that the irritation of ocular rosacea is caused by tiny mites that live in the follicles of the eyelashes, and block the oil glands.

People who are more likely to get both acne and ocular rosacea are fair-skinned and blush easily. They also have a family history of rosacea. There are factors that can make an episode worse even though they don’t cause them. They include:

Alcohol.

Violent emotions.

Stress.

Hot liquids.

Spicy foods.

Sunlight.

Hot and cold weather.

Heavy exercise.

Saunas or very hot baths.

Skin care products that dilate the person’s blood vessels.

Certain medications that also cause the blood vessels to enlarge.

Treatment of Ocular Rosacea

There are several types of ocular rosacea treatment:

Drugs and Ointments

Doctors prescribe ointments that are combinations of steroids and antibiotics to treat ocular rosacea. Tetracylines are popular because they not only clear up bacteria, but treat the plugging of the oil glands around the eyelids by making the oils more viscous. The length of time the patient takes these drugs vary. The drugs are taken orally.

Artificial Tears and a Humidifier

The doctor may prescribe artificial tears for a patient who has dry eyes. These artificial tears may need to be applied as much as four times a day. The patient can also benefit by using a humidifier to keep their eyes moist.

Punctual Plugs

A severe case of dry eyes may need to be treated with punctual plugs. These tiny plugs close up the tear ducts, which ironically helps lubricate the eyes by forcing more moisture over their surface. Plugs can be semi-permanent and removable, or they can be dissolvable. The former are made of silicone, and the latter can be made of collagen, a natural protein that is absorbed by the body over time. In some cases, eye surgery can cauterize the tear ducts.

Prevention

It is up to the patient to avoid those factors which can trigger their ocular rosacea or make it worse. Beyond medications prescribed by the doctor, the patient needs to clean their eyelids daily with a swab moistened by either diluted baby shampoo or plain warm water.

If they are having a flare-up of the disease, they need to avoid makeup. When the condition eases they should wear makeup that does not clog the pores and is fragrance free. Patients should avoid contact lenses while they’re having a flare-up, and apply warm compresses to their eyes to soothe them.

Further Treatments

Clinical trials to treat ocular rosacea are ongoing and include the effects of cyclosporin, intense pulsed light and different antibiotics on the condition.

Summing Up

Ocular rosacea may not be a life-threatening disease, but it is chronic and can affect a person’s quality of life as well as their appearance. Its symptoms, which are largely annoying as opposed to debilitating, can be managed by the patient and their physician.